Organization
4TH GENERATION HOME CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NACOLE TAYLOR (EXECUTIVE DIRECTOR)
(314) 971-9784
Entity
Organization
Contact information
Practice address
2110 MCLARAN AVE, SAINT LOUIS, MO 63136-3850
(314) 971-9784
Mailing address
2110 MCLARAN AVE, SAINT LOUIS, MO 63136-3850
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
02/13/2018
Last updated
02/13/2018
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